RESUME SERVICE FROM A TEMPORARY DISCONNECT

This form is required for those customers who are requesting to resume services following a Temporary Hard Disconnect.

A re-connection fee of $45 will be billed when the service is rendered.

Resume Service after Temporary Disconnect*

Customer Information

Last Name*

First Name*

Lee County Utilities Account Number

Hard Disconnect Start Date*

DL, FEIN, or ID No.*

For security purposes.

Service Address*

Apt/Unit

City*

State*

Zip Code*

Provide Contact Phone Number*

Note: Enter your Email above if you would like to receive a confirmation email

An electronic or manual signature is required when submitting this form. Write your name in the signature area to submit this form electronically (acceptable per Florida Statue 668.50). If an electronic signature is not possible, the form may be printed, signed and submitted in person, via FAX, or by a scanned copy sent via e-mail.

I agree that all information on this form is true and accurate to the best of my knowledge.*

Signature*

Use your mouse or finger to draw your signature above

Cancel